Recently I had an experience that I am not sure how to digest. It feels like a true conundrum.
It was 6 months ago that I walked into my cancer doctor and I would have bet $1,000 that my blood counts were not good. I had just spent the last 30 days really struggling physically with lack of energy and "juice" to get up and be able to physically do very much of anything during any given day. So that morning back in the fall, as I sat in the exam room waiting on my oncologist to share the results of my blood test 30 minutes earlier, I was sure I knew what she was going to tell me…. My blood counts were DOWN from where they should be.
But, to my surprise, Dr. B walked into the room, smiled as she sat down and greeted my wife and I by saying "So, your blood counts look good and have even improved since last month." I was flabbergasted. All I could think was "if my chemistry is good and the chemotherapy is working, why do I feel so crappy?"
We talked through the situation and my doctor ultimately decided to schedule an appointment with a palliative care specialist. My wife was in tears, and I knew why. We lost both our fathers to brain cancer within the past few years, and in both instances, palliative care was the last step of our Dads’ treatments before hospice took over for terminally ill patients.
But Dr. B. reassured both Kate and me that our appointment was not intended to be a precursor to hospice. She explained that her interest was not only in winning the chemistry conflict that leukemia presented in my blood stream, but just as importantly, winning (or at least improving) the "quality of life" battle that it presented as well.
So, I am happy to report that two weeks ago we met a new doctor in the palliative care clinic, and before the appointment was over, I had tears of joy running down my cheeks listening to a doctor who made me feel like he really understood what I was going through. That psychological connection during our visit was as good as any medication he could prescribe. He did modify some meds and explained some other protocols he wanted to try going forward, and overall, it was a terrific visit.
So, back to my conundrum.
Last week, filled with positive energy, I sashayed into my blood test Monday and stood in line with dozens of other cancer patients to have my blood drawn. We all share in the ritual called a "lab and wait" where our blood is drawn between 7-8 AM and then results are immediately processed and shared with patients by their oncologist within an hour or so. This allows doctors to quickly analyze a patient’s condition and if necessary modify protocols and treatment plans to balance out the chemistry issues in a very real time and effective manner.
As I checked in on the ground floor blood clinic at Duke Medical Center, I chit chatted with the phlebotomist (nurse who takes blood) and we laughed and smiled. I felt great that morning, different than so many other mornings in the past few months. After the vials of blood were taken from the top of my left hand, the nurse gave me the choice of a blue or red gauze tape to wrap the small bandage on my hand. I selected blue, but it was "Duke blue," not the preferred Tar Heel blue of my alma mater, but I was in too good a mood to argue with this nice nurse! I then proceeded to the fifth floor to see my oncologist and sat in the exam room smiling and confident that my counts were going to be terrific.
Right on schedule, the doctor entered the small examining room carrying a piece of paper, smiled as she sat down, turned to me and asked “so, how are you feeling?" I told her "Great! Best in a long time!" But I noticed the slight nuance and change in our dialogue. Usually, with good chemistry numbers, she will speak first and share "numbers look good." This time, she asked me first. “Hmmmmm” I thought to myself.
After I shared my delight in my recent daily energy surge, she smiled, was very positive and encouraging as she folded up the sheet with my blood counts on them. Eventually she said "Well, your red blood counts have dropped a little and your white cells are slightly below normal, so we will just keep an eye on them." Hmmmmm again.
Now I know that one data point doesn’t make a trend, but I also know that a trend starts with one data point. Nothing to draw any conclusions, I know, but it certainly has my attention.
So now you know the conundrum I face. Which doctor appointment would I prefer? The one where my chemistry was good, but my energy was poor? Or, the recent one where I walk in feeling full of energy, but my blood counts are down? Hmmmmm.
A conundrum to be sure. Not necessarily one to be solved, perhaps just contemplated.
In the meantime, I am going to enjoy the recent days of energy and juice as much as I can with Kate and the kids and not worry about how long they will last. None of us are guaranteed tomorrow anyway, so my focus is to maximize the joy in today. I hope you will join me in that motto, and do the same.
Amen and AMEN.